A Study of Vitamin D Levels in HIV Seropositive Patients

Abstract

BACKGROUND Vitamin D has an extensive role in immune function and regulation. Cardiovascular disease, Insulin resistance, cell-mediated immunity, autoimmune disease, infections like tuberculosis Vitamin D has a significant role. In autophagy, active form of vitamin D is found to have a role. Low vitamin D levels among HIV infected patients are associated with an increase in mortality, morbidity with a positive correlation between vitamin D levels and CD4 T cells. We wanted to study vitamin D levels in HIV patients, the correlation between CD4 counts and vitamin D levels, the correlation between vitamin D levels and opportunistic infections and also severity of the disease in HIV patients. METHODS A total of 104 confirmed HIV positive patients in KIMS, Hubballi fulfilling inclusion and exclusion criteria were included in the study. Detailed history, examination and lab studies were conducted. RESULTS Among the 104 HIV positive patients, 54 were male and 50 were female patients. 94 (90.4 %) patients had hypovitaminosis D (< 30 ng/ml) and 10 (9.6 %) patients had normal vitamin D levels (> 30 ng/ml). Low vitamin D levels were associated with low CD4 counts with a positive correlation and Pearson correlation value of (+0.87). Low vitamin D levels were associated with severe HIV disease (WHO stage 3 and 4) and with opportunistic infections like TB and oral candidiasis. All these above correlations were found to be statistically significant (P < 0.001). CONCLUSIONS Vitamin D deficiency is frequently observed in HIV positive patients. Low vitamin D levels are associated with low CD4 counts, more severe disease and opportunistic infections. These suggest the importance of vitamin D in HIV positive patients in slowing disease progression and ultimately improving the quality of life and hence its levels need to be checked regularly. KEY WORDS HIV; TB; CD4 Counts; Vitamin D